[Experiences with the Herbert screw].

Matti-Russe grafting has proven effective in the surgical treatment of scaphoid non-union. Old or recurrent cases as well as the small proximal fragment give rise to problems. Stabilization with the Herbert screw in addition to cancellous bone grafting has proven effective in such problematical cases. Proximally located fractures also constitute an indication for primary surgery. This does not only improve the chances of healing, but also substantially shortens the period of immobilization. We have treated 34 non-unions and 12 fractures with this method between 1989 and 1990; these were mainly problem cases. The follow-up examinations show convincing results: all fractures healed primarily with plaster-cast immobilization for two to three weeks. In non-union cases, consolidation did not occur in two patients, but the fragments were rendered sufficiently stable by the screw. The mobility of the wrist and the period of the rehabilitation were also favorably affected by the short period of immobilization (four to six weeks). A disadvantage in the operation is the extensive exposure and subluxation of the STT-joint, which is why we have modified the reposition jig.